Author of

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Epidemiology and outcomes (ID 57)

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200PD - High physician confidence does not predict rate or type of treatment change for cases discussed at a thoracic multidisciplinary cancer conference: A case series in a tertiary cancer center (ID 602)

Background: Multidisciplinary cancer conferences (MCCs) aim to improve the management of patients with cancer. We evaluated the rate and type of decision change that occurred at a thoracic MCC.

Methods: The MCC took place from June-December 2017 at a Canadian tertiary cancer center and involved surgeons, oncologists, pathologists and radiologists. Cases were brought forward by treating physicians. Using a standardized MCC intake form, physicians articulated a clinical question, original treatment plan, and confidence in the original plan (rated on a 1–5 scale). Major changes were classified as: change from upfront surgery to neoadjuvant treatment, definitive chemotherapy/radiation, or Stereotactic Body Radiation Treatment/Radiofrequency Ablation (SBRT/RFA); change from neoadjuvant or definitive chemotherapy/radiation or SBRT/RFA to surgery; or palliation/observation instead of definitive treatment. Minor changes included additional imaging, further staging investigations, repeat consultations, or changes in planned oncologic or surgical approach. Data were reported as frequencies. Chi-square tests were used to compare groups at a p < 0.05 significance level.

Results: A total of n = 116 cases were reviewed at the MCC. Ninety-six percent of cases required a re-review of imaging or pathology (111/116). Sixty percent (70/116) of cases resulted in a treatment change, with 41% (29/70) and 59% (41/70) of changes considered major and minor, respectively. High physician confidence in the original plan did not significantly correlate with the rate of change (53% no change; 47% change, p = 0.073) or type of change (30% major; 70% minor, p = 0.098). The most common major change was use of neoadjuvant or definitive chemotherapy/radiation instead of upfront surgery (38%, 11/29). Minor changes primarily involved further staging investigations (56%, 23/41).

Conclusions: Sixty percent of cases discussed at the thoracic MCC resulted in a treatment change, with 41% considered major changes. High physician confidence did not significantly correlate with the rate or type of change. These data support the continued implementation and use of MCCs.

Clinical trial identification:

Legal entity responsible for the study: McMaster University

Funding: Has not received any funding

Disclosure: All authors have declared no conflicts of interest.

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